Transradial Comaneci-assisted coiling of a direct carotid-cavernous fistula

Roger Barranco Pons; Valerio Da Ros; Jacopo Scaggiante; Greicy Muniz da Silva; Eliseo Picchi; Francesca Di Giuliano; Lucia Aja Rodriguez; Oscar Chirife Chaparro

doi:10.1016/j.radcr.2019.09.001

Transradial Comaneci-assisted coiling of a direct carotid-cavernous fistula

Radiol Case Rep. 2019 Oct 31;14(12):1554-1557. doi: 10.1016/j.radcr.2019.09.001. eCollection 2019 Dec.

Authors

Roger Barranco Pons¹, Valerio Da Ros², Jacopo Scaggiante², Greicy Muniz da Silva¹, Eliseo Picchi², Francesca Di Giuliano², Lucia Aja Rodriguez¹, Oscar Chirife Chaparro¹

Affiliations

¹ Department of Interventional Neuroradiology, Bellvitge University Hospital, C/Feixa Llarga s/n 08017. Hospitalet de Llobregat, Barcelona, Spain.
² Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome Tor Vergata, Viale Oxford, 8100133 Rome, Italy.

Abstract

Direct carotid-cavernous fistula is a communication between the internal carotid artery and the cavernous sinus, most of the times established following trauma or rupture of a cavernous aneurysm. The most commonly used treatments (coils, detachable latex balloons, stents, or liquid agents) carry ischemic or hemorrhagic risks, related to hemodynamic diversion of cerebral blood flow or permanent dual antiplatelet therapy. We report a case of coiling of a carotid-cavernous fistula assisted by the Comaneci, a temporary adjustable bridging mesh (Rapid Medical, Israel), to avoid transarterial or -venous migration. In our experience, Comaneci-assisted coiling represents a feasible solution to maintain patency of the distal vessels during coiling and avoid dual antiplatelet medications, even using a transradial approach.

Keywords: Comaneci; Direct carotid-cavernous fistula; Embolization; Radial access; Stent.

Publication types

Case Reports